Indemnity provision for IMUK midwives is 'inappropriate', says NMC

13 January 2017

The Nursing and Midwifery Council (NMC) today announced that it had decided that the indemnity scheme used by some independent midwives who are members of the organisation Independent Midwives UK (IMUK) is inappropriate.

The NMC felt it had to take this unprecedented step following a detailed investigation into the indemnity scheme provided for midwife members of the organisation Independent Midwives UK (IMUK). The investigation showed that around 80 independent midwives were relying on a scheme that had inadequate funds to settle significant claims should harm come to a woman or their baby during childbirth.

It has been a legal requirement since 2014 for all healthcare professionals – including midwives - to have an indemnity arrangement in place. The Government brought in this requirement to ensure that there was adequate redress for women and families should anything happen to them or their babies during birth. Almost all the UK’s midwives are properly covered by an appropriate scheme.

The NMC’s investigation found that the indemnity scheme provided for IMUK members was not able to call upon sufficient financial resources to meet the costs of a successful claim for damages for a range of situations. These include the rare cases of catastrophic injury, such as cerebral palsy. This could have the effect that mothers and babies who suffer injury through the negligence of an attending midwife are not properly compensated for their injury.

Chief Executive and Registrar of the NMC, Jackie Smith, said:

“The NMC absolutely supports a woman’s right to choose how she gives birth and who she has to support her through that birth. But we also have a responsibility to make sure that all women and their babies are provided with a sufficient level of protection should anything go wrong.”

“We have been in dialogue with IMUK for some considerable time to try and resolve our concerns about their indemnity provision. Our priority has always been to ensure the safety of women and their families.

“It is extremely disappointing that the NMC learned today that some IMUK midwives have only just informed their clients of the issues connected with their indemnity cover, despite knowing of the NMC’s concerns for several months.”

A very small number of the UK’s midwives work on a self-employed basis, providing midwifery support to women during childbirth on a private basis. The majority of these independent midwives have adequate indemnity insurance. The decision today only applies to around 80 members of IMUK who rely on their indemnity scheme. In contrast, more than 41,000 midwives in the UK operate with adequate indemnity cover.

The NMC wrote to IMUK and their midwives in August 2016 to tell them that, after investigation, the NMC did not consider that their indemnity provision provided appropriate cover. We made clear to IMUK that if the provider did not increase its available resources, then its member midwives would have to secure an alternative arrangement or they would face removal from the NMC’s register to ensure that women were protected. Unfortunately IMUK’s indemnity provider has either not been able or not been willing to increase its resources from its members, other sources, or by way of an additional insurance layer since that time.

After giving IMUK and their midwives a further opportunity to secure alternative indemnity provision, the NMC wrote again to IMUK and their midwives in December 2016 to tell them that our final decision was that their scheme was not appropriate. Once the final decision was reached by the Registrar, the NMC had to act quickly in the interests of public safety.

Throughout this process, the NMC has worked closely with the NHS in England to ensure that the women cared for by IMUK midwives are supported and have access to alternative support. We have also made clear throughout that the midwives affected can carry on providing midwifery care to women if they secure alternative indemnity cover to that provided by IMUK’s indemnity provider.

IMUK members have all now confirmed to the NMC that they will not rely on the IMUK indemnity scheme and some have secured alternative cover and have been able to continue providing care to their clients.

The Nursing and Midwifery Council (NMC) is the independent professional regulator for nurses and midwives in the UK. We exist to protect the public. We do this by maintaining the register of qualified nurses and midwives and setting standards of education, training, conduct and performance. We make sure that nurses and midwives keep their skills and knowledge up to date through a regular revalidation process. If concerns are raised about the standards of a registered nurse or midwife, we have a duty to investigate and, where necessary, take action to protect the public.